Assessment of the Minimum Clinically Important Difference in the Timed Up and Go Test After Surgery for Lumbar Degenerative Disc Disease
Assessment of the Minimum Clinically Important Difference in the Timed Up and Go Test After Surgery for Lumbar Degenerative Disc Disease
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DOI：
10.1227/neu.0000000000001320
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发表时间：
2017-03-01
期刊：
影响因子：
4.8
通讯作者：
Smoll, Nicolas R.
中科院分区：
文献类型：
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作者：
Gautschi, Oliver P.;Stienen, Martin N.;Smoll, Nicolas R.
背景技术背景：计时启动测试（TUG测试）此前已被描述为评估退行性椎间盘疾病患者客观功能障碍的可靠工具。目的：本研究的目的是评估TUG测试的最小临床重要差异（MCID）。方法：拉扯测试（以秒为单位测量）与经验证的患者报告的疼痛强度结局指标（PRO）相关（背部和腿部疼痛视觉模拟量表）、功能障碍（奥斯韦斯特里残疾指数、罗兰莫里斯残疾指数）和健康相关生活质量测量（简表-12和EuroQol 5D）。使用以下PRO的应答者，使用三种已建立的方法建立基于锚点的MCID值（视觉模拟量表背部和腿部疼痛，奥斯韦斯特里残疾指数，罗兰莫里斯残疾指数，EuroQol 5D指数和简表-12身体成分总结）作为锚点：（1）平均变化，（2）最小可检测变化，和（3）变化差异方法。研究了100例患者，平均+/-SD年龄为56.2 +/-16.1岁，57例（57%）为男性，45例患者接受了显微椎间盘切除术，35例患者接受了腰椎减压术，20例患者接受了融合术。3种MCID计算方法显示了根据PRO使用的MCID值范围，从0.9 s（基于变化差异方法的奥斯韦斯特里残疾指数）到6.0 s（基于最小可检测变化方法的EuroQol 5D指数），所有测量的PRO的平均MCID为3.4 s。结论：TUG测试时间的MCID高度可变，取决于使用的计算技术。使用所有3种方法和所有锚钉的平均TUG测试MCID为3.4 s。
BACKGROUND: The Timed Up and Go Test (TUG Test) has previously been described as a reliable tool to evaluate objective functional impairment in patients with degenerative disc disease.OBJECTIVE: The aim of this study was to assess the minimum clinically important difference (MCID) of the TUG Test.METHODS: The TUG Test (measured in seconds) was correlated with validated patient-reported outcome measures (PROs) of pain intensity (Visual Analog Scale for back and leg pain), functional impairment (Oswestry Disability Index, Roland Morris Disability Index), and health-related quality of life measures (Short Form-12 and EuroQol 5D). Three established methods were used to establish anchor-based MCID values using responders of the following PROs (Visual Analog Scale back and leg pain, Oswestry Disability Index, Roland Morris Disability Index, EuroQol 5D index, and Short Form-12 Physical Component Summary) as anchors: (1) average change, (2) minimum detectable change, and (3) change difference approach.RESULTS: One hundred patients with a mean +/- SD age of 56.2 +/- 16.1 years, 57 (57%) male, 45 patients undergoing microdiscectomy, 35 undergoing lumbar decompression, and 20 undergoing fusion surgery were studied. The 3 MCID computation methods revealed a range of MCID values according to the PRO used from 0.9 s (Oswestry Disability Index based on the change difference approach) to 6.0 s (EuroQol 5D index based on the minimum detectable change approach), with a mean MCID of 3.4 s for all measured PROs.CONCLUSION: The MCID for the TUG Test time is highly variable depending on the computation technique used. The average TUG Test MCID was 3.4 s using all 3 methods and all anchors.